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At)-A08S 912 TECMflCN1CS INC OAKTON VA P/0g 9/9A SYSTEM APPROAC" TO NAVY MEDICAL EDUCATION AND TRAINING. A~PEN-rTC(AUS 711M01-6--2

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APPENDIX 43.

COMPETENCY CURRICULA FORHOSPITAL ADMINISTRATIVE ASSISTANT

ANDHOSPITAL ADMINISTRATIVE TECHNICIAN

APPLICATION OF A SYSTEM APPROACHU.S. NAVY MEDICAL DEPARTMENT

EDUCATION- AND TRAINING PROGRAMSFINAL REPORT Tl '

JUN 2 4 980Df

CPrepared under Contract toOFFICE OF NAVAL RESEARCH

U.S. DEPARTMENT OF THE NAVYIQuida C. Upchurch, Capt., NC, USN

Program ManagerEducation and Training R&D

Bureau of Medicine and Surgery (Code 71G)

I itribuluM UsITT

WIC LASS I F IED

Ifr epTort~~ (Vols. I & II) T

/ A System Approach to Navy MedicalEductl n an Trinin -0 FINAL REPTo

- 8.,r"M7 CONTRACT OR GRANTr NUMBER~o)

( ) / ~ I .///t/r'/.tNOX14-694-046

~Rrlt~i r-*~~10. PROGRAM ELeEmE r. PROJZCT, TASK

Office of Naval Research AREA & WORK UNIT NUMBERS

Department of the NavyArlington, Virginia 22217 43-03X.02

11. CONTROLLING OFFICE %AM E AND ADDRESS 12. REPORT DATE

Office of Naval Research A"7Department of the Navy 13. -NUMBER OF' PAGE9Arlington, Virginia 22217 _____________

1. MONITORING AGENCY NAME 11 ADORESS(11 dIl.ro"I fro C.11olj01114 Ofce) IS. SECURITY CLASS. lof thia poe)

Office of Naval ResearchDepartment of the Navy .UNCLASSIFIED

Arlington, Virginia 22217 - 13m. DECIFI CATION/ OWNGRtAINGSCEDLIS1. DISTRIBUTION STATEMENT (of (hit Report)

Approved for public release; distribution unlimited.

17. DISTRIBUTION STATEMENT (of the abotrAct entered in,9leek 20. It difiv.,.nt"o Report)

Approved for public release; distribution unlimited.

IS. SUPPLEMENTARY NOTES

1 None

19. KEY WORDS (Continue on rover&* side If nocesars And Idantilp by block number)

Education and Training Medical TechnicianMedical Training Job AnalysisNurse Training Task Analysis

Dentist Training Curriculum Development20.1 AOSTRAT (Continue onrg cve,., old* If necooo.v mdld..110y b, IIlock number)

The study objective consisted of a determination of what the health carepersonnel in the Navy's Medical Department, Bureau of Medicine and Surgeryactually do in their occupations; improving the personnel process (educa-

* tion and training); and building a viable career pathway for all health* care personnel. Clearly the first task was to develop a system of job

analyses applicable to all system wide health care manpower tasks. Ameans of postulating simplified occupational clusters covering some 50

OD I JOA 1 1473 EDITION OF I NOV 65 IS OBSOLETEUN L S I ED*#e--S/N OIO2*OIl* 6603 1 NLSSFE

SECURITY CLASSIFICATION OF THIS PAGE (Men Dater." .*ed

UNCLASSIFIED__,,4iTY CLASS#FfCA'I0N OF TH~IIS PAGE(~,. n Date Sned)

currently designated Navy enlisted occupations, 20 Naval Enlisted Classi-fication Codes (NEC's) were computerized. A set of 16 groupings thatcover all designated occupations was developed so as to enhance the ef-fectiveness of professionals and sub-professionals alike.

-'flfl 3unced

D4, • t.rih:tion |

iiir V it do

~i3 rnpecial1

UNCLASSIFIED.aCUleTY CLAECATION OF ?"Is PA@( Dos. u,,

II FOREWORD

The project, "Application of a System Approach to the NavyMedical Department Education and Training Programs," wasinitiated in May of 1969 as a realistic, comprehensive responseto certain objectives set forth in ADO 43-03X, and to memorandafrom both the Secretary of Defense and the Assistant Secretaryof Defense, Manpower and Reserve Affairs. The Secretary'sconcern was stated in his memorandum of 20 June 1965, "Innovationin Defense Training and Education." More specific concerns werestated in the Assistant Secretary's memorandum of 14 June 1968,"Application of a System Approach in the Development and Managementof Training Courses." In this he called for "vigorous andimaginative effort," and an approach "characterized by anorganized training program with precise goals and definedoperationa!.interrelation among instructional system components."He also noted, "Job analyses with task descriptions expressedin behavioristic terms are basic and essential to the developmentof precise training goals and learning objectives."

The Project

System survey and analysis was conducted relative to allfactors affecting education and training programs. Subsequently,a job-analysis sub-system was defined and developed incorpo-

I rating a series of task inventories ". . . expressed inbehavioristic terms . . ." These inventories enabled the gatheringof job activity data from enlisted job incumbents, and datarelating to task sharing and delegation from officers of the

IMedical, Nurse and Dental Corps. A data management sub-systemwas devised to process incumbent data, then carry out neededanalyses. The development of initial competency curriculabased upon job analysis was implemented to a level of methodologydetermination. These methods and curriculum materials constituteda third (instructional) sub-system.

Thus, as originally proposed, a system capability has beendeveloped in fulfillment of expressed needs. The system, however,remains untested and unevaluated. ADO 43-03X called forfeasibility test and cost-effectiveness determination. Theproject was designed to so comply. Test and evaluation throughthe process of implementation has not proved feasible in theNavy Medical Department within the duration of the project.As designed and developed the system does have " . . . precisegoals and defined operational interrelation among instructionalsystem components." The latter has been achieved in terms of arecommended career structure affording productive, rewardingmanpower utilization which bridges manpower training and healthcare delivery functions.

. . .III I I II I

Data Management Sub-System

Job analysis, involving the application of comprehensivetask inventories to thousands of job incumbents, generates manymillions of discrete bits of response data. They can beprocessed and manipulated only by high speed computer capabilityusing rigorously designed specialty programs. In addition tonumerical data base handling, there is the problem of rapidlyand accurately manipulating a task statement data base exceedingten thousand carefully phrased behavioral statements. Throughthe use of special programs, task inventories are prepared,printouts for special purposes are created following a jobanalysis application, access and retrieval of both data andtasks are efficiently and accurately carried out, and specialdata analyses conducted. The collective programs, techniquesand procedures comprising this sub-system are referred to as theNavy Occupational Data Analysis Language (NODAL).

Job Analysis Sub-System

Some twenty task inventory booklets (and associated)response booklets) were the instruments used to obtain jobincumbent response data for more than fifty occupations. Aninventory booklet contains instructions, formatted questionsconcerning respondent information ("bio-data"), responsedimension definitions, and a list of tasks which may vary innumber from a few hundred to more than a thousand peroccupational field.

By applying NODAL and its associated indexing techniques,it is possible to assemble modified or completely differentinventories than those used in this research. Present inven-tories were applied about three years ago. While they havebeen rendered in operational format, they should not bereapplied until their task content is updated.

Response booklets were designed in OPSCAN mode for easeof recording and processing responses.

Overall job analysis objectives and a plan of administrationwere established prior to inventory preparation, including thesetting of provisional sample target sizes. Since overall dataattrition was forecast to approximate twenty percent, finalsample and sub-sample sizes were adjusted accordingly. Stratifiedrandom sampling techniques were used. Variables selected (suchas rating, NEC, environment) determined stratifications, togetherwith sub-population sizes. About fifteen percent of large sub-populations were sought while a majority of all members of smallsub-populations were sought.

Administration procedures were established with great carefor every step of the data collecting process, and were coor-dinated with sampling and data analysis plans. Once set, theprocedures were formalized as a protocol and followed rigorously.

4

IInstructional Sub-System

Partial "competency curricula" have been composed as anintegral sub-system bridging what is required as performanceon the job with what is, accordingly, necessary instructionin the training process. Further, curriculum materials weredeveloped to meet essential requirements for implementing thesystem so that the system could be tested and evaluated forcost effectiveness. However, due to the fact that test andevaluation was not feasible in the Navy Medical Departmentwithin the duration of the project, it was not possible tocomplete the development of the system through the test andevaluation phase. The inability to complete this phase alsointerrupted the planned process for fully developing thecurricula; therefore, instead of completed curricula ready foruse in the system, the curricula were partially developed toestablish the necessary sub-system methodology. Thecompetency curricula are based on tasks currently performedby job incumbents in 1971. (The currency of a given curriculumdepends upon periodic analysis of incumbents' jobs, and itsquality control resides in the evaluation of the performancecompetency of the program's graduates.)

A competency curriculum provides a planned course ofinstruction or training program made up of sequenced competencyunits which are, in turn, comprised of sequenced modules. Thesemodules, emphasizing performance objectives, are the foundationof the curriculum.

A complete module would be comprised of seven parts: acluster of related tasks; a performance objective; a list ofknowledges and skills implied by the objective; a list ofinstructional strategies for presenting the knowledges andskills to the learner; an inventory of training aids forsupporting the instructional strategies; a list of examinationmodes; and a statement of the required training time. Inthis project, curriculum materials have been developed tovarious levels of adequacy, and usually comprise only the firstthree parts; the latter four need to be prepared by the user.

The performance objective, which is the most crucial partof the module, is the basis for determining curriculum content.It is composed of five essential elements: the stimulus whichinitiates the behavior; the behavior; the conditions underwhich the behavior takes place; the criteria for evaluating thebehavior; and the consequence or results of the behavior. Asixth element, namely next action, is not essential; however,it is intended to provide linkage for the next behavior.

Knowledges and skills listed in the module are those neededby the learner for meeting the requirements of the performanceobjective.

[

Instructional strategies, training aids, examination modesand training time have been specified only for the Basic HospitalCorps Curriculum. The strategies, aids and modes were selectedon the basis of those considered to be most supportive inpresenting the knowledges and skills so as to provide optimumlearning effectiveness and training efficiency. The strategiesextend from the classroom lecture as traditionally presentedby a teacher to the more sophisticated mediated program forself-instruction. The training aids, like strategies, extendfrom the traditional references and handout material in theform of a student syllabus to mediated programs for self-instruction supported by anatomical models. Examination modesextend from the traditional paper and pencil tests to proficiencyevaluation of program graduates on the job, commonly known asfeedback. Feedback is essential for determining learningeffectiveness and for quality control of a training program.The kind of instructional strategies, training aids and examinationmodes utilized for training are limited only by such factorsas staff capability and training budget.

The training time specified in the Basic Hospital CorpsCurriculum is estimated, based upon essential knowledge andskills and program sequence.

The competency curriculum module, when complete, providesall of the requirements for training a learner to perform thetasks set forth in the module. A module may be used independentlyor related modules may be re-sequenced into modified competencyunits to provide training for a specific job segment.

Since the curricula are based upon tasks performed by jobincumbents in 1971, current analysis of jobs needs to be accom-plished using task inventories that have been updated to reflectchanges in performed tasks. Subsequent to job analysis, arevision of the curricula should be accomplished to reflect taskchanges. When the foregoing are accomplished, then faculty andother staff members may be indoctrinated to the competencycurricula and to their relationship to the education and trainingsystem.

In addition to the primary use for the systematic trainingof job incumbents, these curricula may be used to plan for newtraining programs, develop new curricula, and revise existingcurricula; develop or modify performance standards; develop ormodify proficiency examinations; define billets; credentializetraining programs; counsel on careers; select students; andidentify and select faculty.

Iiw

iT "' ,'_ __W

'.. - - .... _ _, .

I,The System

i Three sub-systems, as described, comprise the proposedsystem for Education and Training Programs in the Navy MedicalDepartment. This exploratory and advanced developmental researchhas established an overall methodology for improved educationand training incorporating every posaible means of providingIbases for demonstrating feasibility and cost effectiveness.( There remains only job analysis sub-system up-dating, instruc-tional sub-system completion, and full system test andevaluation.

Acknowledgements

The authors wish to acknowledge the invaluable participationof the several thousands of Naval personnel who served asrespondents in inventory application. The many military andcivilian personnel who contributed to developmental effortsare cited by name in the Final Report.

The authors also wish to acknowledge former colleaguesfor singularly important contributions, namely, Elias H. Porter,Ph.D., Carole K. Kauffman, R.N., M.P.H., Mary Kay Munday, B.S.N.,R.N., Gail Zarren, M.S.W., and Renee Schick, B.A.

IIdentity and acknowledgement of the project Advisory Groupduring the project's final year is recorded in the Final Report.

I Lastly, the project could not have been commenced norcarried out without the vision, guidance and outstandingdirection of Ouida C. Upchurch, Cipt., NC, USN, Project Manager.

%I

I.

[l

ITABLE OF CONTENTS

COMPETENCY CURRICULA FOR

HOSPITAL ADMINISTRATIVE ASSISTANT

AND

j HOSPITAL ADMINISTRATIVE TECHNICIAN

[HOSPITAL ADMINISTRATIVE ASSISTANT

Units/Modules Page

I. Clerical Operations ........ ................ 1

1. Log Maintenance Procedures. ........... 22. Routine Daily Filing....... ........ . . . 33. Maintenance of the Visible Filing System . . . . 4

II. Patient Charts . ................. 5

1. Patient Chart Assembly ...... ............ 62. Patient Chart Recording ............. 73. Maintenance of Patient's Charts . . . . . . .. 8

III. Coordination .......... .................... 9

1. Internal Communications ... ......... . . . 102. Support Service Coordination .......... 11

IV. Ward Support ...... . . . . . . . ....... 12

1. General Ward Support ... .......... 132. Ward Security Procedures . . . . . . . . . .. 14

V. SUpply Procedures .................... 15

1. Procurement and Inventory of Ward Supplies . . . 162. Inventory and Requisition Procedures . . . . 173. Maintaining and Transporting Supplies and

Equipment . . . . . . . . . . . . . . . .. . 184. Linen Exchange Procedures . . . . . ....... 19

HOSPITAL ADMINISTRATIVE TECHNICIANI

I. Clerical Operations . . . . . . . . . . . . . . . . 20

a

IUnits/Modules

1. Statistical Data Collection and Analysis ... ..... 212. Work Order/Work Request ... ............. .. 223. Admission and Transfer of Patient ......... . 23

I. Supply Procedures ....................... . 24

1. Local Supply and Equipment Purchase ....... .. 252. Supply and Equipment Accountability ....... .. 263. Survey of Supplies and Equipment ........... .. 27

Ill. Personnel Recall ......................... .. 28

1. Personnel Recall .................... 29

II

II

I

HI1

I

'I.. . .. I _-_ _ _ • rl I- | I

i ~ I | I -

IIII HOSPITAL ADMINISTATION

ASS ISTANTIII1I

i ,I

IIII

iI,

_____.. - .. , ....... . im;

ICompetency: HOSPITAL ADMINISTRATIVE ASSISTANT (HAA)ICOMPETENCY UNIT I: CL7RICAL OPERATIONSIThi3 unit includes the following modules:

Number Title Page

1 Log Maintenance Procedures ... ........ 2

2 Routine Dail, Filing ................ 3

1 3 Maintenance of the Visible Filing System 4

IIII

I

i I

Competency: HOSPITAL ADMINISTRATIVE ASSISTANT (HAA)

Unit I: Clerical Operations

MODULE 1: LOG MAINTENANCE PROCEDURES

TASKS a. Make entries into ward log, e.g., unusualevents, shift summary

b. Log in patients to clinic/department/sickcall

c. Ensure that patients log in and out of thedepartment

d. Log standard form 519A results

PERFORMANCE OBJECTIVE

(Stimulus) Upon receipt of any test results, at the end ofa shift, when an unusual event occurs or whenordered by the ward supervisor

(Behavior) The HAA will log lab or x-ray results in theproper log book, maintain the patient's in/outlog book; ensure that each patient complies withward procedures, log all incoming standard form519A results onto the proper records and instructother ward personnel in log book procedures andmaintenance

(Conditions) With minimal supervision(Criteria) Ward and unit logs will be established in

accordance with ward/local commind proceduresand BuMed regulations; routine/unusual eventsand shift summary report will be entered se-quentially into the correct log book; all logentries will be clear, concise and contain onlypertinent information

(Next Action) Visually check all log entries for correctnotations and utilization and make any necessarycorrections

KNOWLEDGES AND SKILLS

Required log booksKinds of information to be recordedRecording proceduresStandard medical terminologyKnowledge of staffApplicable BuMed regulationsKinds of information to be recorded by ward

supervisor or nurse in charge, i.e., pro-fessional medical notations

Instructional techniquesUse, operation and preventive maintenance of

office equipment, e.g., typewriter, manualAddressograph machine, photocopier (e.g.,Xerox)

2

ICompetency: HOSPITAL ADMTNISTRATIVE ASSIST7NT (liLA)

I Unit I: Clerical Operations

I NODULE 2: ROUTINE DAILY FILING

TASKS a. Perform routine daily fil.nqb. Select required document fron filesc. Prepare necessary forms and chits, e.g.,

special request, materials requestedd. Assemble patient's record for physician's

review


I (Stimulus) Upon receipt and/or completion of forms andrecords or when directed by ward supervisor

(Behavior) The HAA will correctly file completed formsand records, select and assemble patient'srecords for daily review by the physicianand, when admitting or discharging patient'sassemble and check patient's chart prior to

the physician's review(Conditions) Without supervision; using patient's chart,

forms, records(Criteria) Patient's record and all necessary forms and

requests are accurately completed in all detailsaccording to local command procedures and/orBuMed regulations

(Next Action) Submit patient's chart to the appropriatephysician for review and approval; carry forms

and chits to central medical supply for issuanceof necessary materials; complete routine filingand ensure that an efficient system is utilizedto maintain accurate and easily accessablerecords


Location of forms and chitsFiling system used, e.g., alpha, numericalFiling procedures for charts/forms/chitsTypes and sequence of forms contained in chartsUse, operation and preventive maintenance of

office equipment, e.g., typewriter, manualAddressograph machine, photocopier (e.g., Xerox)

Local command proceduresRelevant BuMed regulationsAbility to write and print legiblyAccuracy in filing and checking

I

i ig

C(.-e tency: HOSPITAL ADMINISTR.TIVE ASSISTANT (AA)

Unit I: Clerical Procedures

MODU7LE 3: MAINTENANCE OF TFE VISIBLE FILING SYSTEM

TASKS a. Prepare nominal index cards on inpatientsb. Search files for patient nominal index cardc. Maintain an accurate visible file system


(Stimulus) Upon commencement of a ward assignment and whendirected by the ward supervisor

(Behavior) The HAA will prepare nominal index cards for apatient arriving on the ward, search files fora patient's index card, when necessary, andmaintain the visible file

(Conditions) Without supervision(Criteria) Preparing and maintaining the visible file

according to ward and local command proceduresand/or BuMed regulations; employing the propersecurity procedures while using the visiblefiling system

(Consequence) Accurate record of all patients on the ward


NAVMED 6300/5Procedures for establishing and maintaining a

visible filing systemVisible filing system security proceduresOrganizationRelevant ward procedures, local command proce-dures and BuMed regulations

Use, operation and preventive maintenance ofoffice equipment, e.g., typewriter, manualAddressograph machine, photocopier (e.g.,Xerox)

4

1Competency: HOSPITAL AOMINISTraTIVE ASSISTANT (HAA)ICOMPETENCY UNIT II: PATIENT ChARTS

This unit includes the following modules:

Number Title Pace

1 Patient Chart Assembly ............. 6

2 Patient Chart Recording ........... 7

1 3 Maintenance of Patient's Charts ... ...... 8

-iII

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Unit II: Patient Charts

MODULE 1: PATIENT CHART ASSEMBLY

TASKS a. Prepare x-ray reports for physician tocomplete

b. Obtain patient's past hospitalizationrecords and x-rays

c. Assemble chart and requisitions for physicalexamination

PERFOPMANCE OBJECTIVE

(Stimulus) upon admission of patient to the ward and

physician's request(Behavior) The HAA will prepare needed charts for the

physician to complete after patient work-up andexamination, prepare lab, x-ray or other neces-sary examination requisitions, and properlyassemble all items into a complete, accurateclinical chart for review by the physician

(Conditions) With minimum supervision; using required forms,records and charts

(Criteria) According to physician's orders, establishedprocedures and ward and local command policies

(Next Action) Chart patient information


Location of filesRequired forms contained in chartSequence of forms in chartRecognition of normal/abnormal test resultsordered

Transcription of physician's orders to properrequest forms

Location of patient charts on the ward or inpatient administration department

Security procedures for chartDestination of assembled chartAccuracy in typing and printingEffective communication skillsFiling procedures

6

2'H

iCompetency: HOSPITAL ADMINISTRATIVE ASSISTANT (HAA)


MODULE 2: PATIENT CHART RECORDING

TASKS a. Chart/graph datab. Enter patient identification information

onto required reports and recordsc. Log and record analysis resultsd. Fill out/complete casualty card (NAVMC

10453-PO)e. Log x-ray numbers or identification onto

records

f. Graph patient data, vital signs, intake andoutput


(Stimulus) Upon request(Behavior) The HAA will chart data; enter patient identi-Jfication information onto reports received; log

lab analysis, x-ray reports, vital signs, intakeand output results and/or other test results,and complete casualty card

(Conditions) With minimal supervision by the head nurse ornurse in charge

T (Criteria) Information recorded according to ward procedures,local command procedures and/or BuMed regulations;missing forms traced back to the cognizant sectionsand completed for charting purposes as expeditiouslyas possible

(Consequence) Maintenance of inpatient charts


Identification required on formsHow and where to log analysis resultsCharting procedures and use of graphsPersonnel authorized to use chartsLegal implications of chartingRelevant ward procedures, local command procedures

and BuMed regulations

III

Competency: HOSPITAL ADMINISTRATIVE ASSISTANT (BAA)


MODULE 3: MAINTENANCE OF PATIENT'S CHARTS

TASKS a. Maintain daily records of procedures/examinations performed on patient

b. Assemble patient chart/records/x-rays forpre-op

c. Assess completeness of lab reportsd. Stuff/thin/pull patient's chart


(Stimulus) After checking the patient's chart and whenordered by the ward supervisor

(Behavior) The HAA will maintain daily records of proceduresand examinations performed on each patient onthe ward; assemble patient charts on a dailybasis for the physician's review; prepare labforms and other types of requests for examinationprocedures, according to physician's orders;assemble patient's chart, records, x-rays forpre-op, and assure the nurse in charge of theaccuracy and completeness of the patient's chartand records prior to surgery

(Conditions) With minimal supervision by the ward supervisor(Criteria) Accurately and efficiently according to ward/local

command procedures and physician's orders(Consequence) This action will produce proper patient care

schedule and updated patient clinical chart onthe ward


Type of test/procedure orderedReporting/recording proceduresProcedures to assemble patient's chart, records,

x-rays for physician's reviewPertinent ward/local command procedures andBuMed regulations

S i,

_ II

ICompetency: HOSPITAL ADMINISTRATIVE ASSISTANT (HA.A)

COMPETENCY UNIT III: COORDINATIONIThis unit includes the following modules:

Number Title Paq

I Internal Comrnunications ............. 10

2 Support Service Coordination ... ....... 11

IIiII

II

lIIi

Ii9

I

Competency: HOSPITAL ADMINISTRATIV7 ASSISTANT (HAA)

Unit III: Coordination

MODULE 1: INTEMAL COMUNICATIONS

TASKS a. Inform hospital authorities of eachpatient's condition

b. Inforr ward personnel of administrativecommunications


(Stimulus) Routinely and when necessary(Behavior) The HAA will keep ward personnel informed and

up-to-date on all administrative communicationsand directives and, in conjunction with theward supervisor or nurse in charge, will informhospital authorities of a patient's being placedon or removed from the seriously or very seriouslyill list

(Conditions) Without supervision; using log books, requiredforms

(Criteria) Following the chain of comriand; according to wardand local command procedures

(Consequence) These actions result in orderly, timely flow ofrequired information to all personnel

(Next Action) Take required action to ensure that all personnelare correctly using the communications systprm


Required formsCommunications systemChain of commandCriteria for various patient condition designa-

tions, e.g., serious or very serious

10

II


Unit III: Coordination

MIODULE 2: SUPPORT SERVICE COORDINATION

TASKS a. Coordinate with hospital/department supportservices, e.g., social services, Ped Cross

b. Contact other departments to obtain andcoordinate patient/personnel appointments

c. Coordinate ambulance requests


(Stimulus) Upon physician's orders(Behavior) The HAA will coordinate all support services

(e.g., social services, Red Cross or visitinggroups of celebrities) with the ward medicalstaff, will organize and obtain needed appoint-ments from the various departments, and willcoordinate all ambulance requests received

(Conditions) With minimal supervision(Criteria) According to ward, hospital and local command

procedures(Consequence) Correct coordination of appointments and support

services, resulting in less loss of time andservices, better patient care and greater effi-1 ciency within all departments

KNOWLEDGES AND SKILLS1

Procedures for scheduling appointmentsEffective coordination proceduresDaily work schedule adjustmentsCommunications skillsProcedures for coordinating ambulance requests

i

11

Competency: HOSPITAL ADMINISTRATIV'E ASSISTANT (HAA)

COMPETENCY UNIT IV: WARD SUPPORT


Number Title

1 General Ward Support ... ........... . 13

2 Ward Security Procedures .......... .. 14

12

ICnmpetency: HOSPITAL ADMIN:TR'-TI' ASSISTA :T (HAA)

I Unit IV: Ward Support

IMODULE 1: GENERAL WPARD SUPPORT

TASKS a. Prepare patients/ward for physician'srounds

b. Receive patients on arrival, e.g., introduceself, obtain patient's name, ensure patient'scomfort

I PERFORMANCE OBJECTIVE

(Stimulus) Routinely and/or upon the arrival of a newpatient on the ward

(Behavior) The HAA will greet an arriving patient and orienthim regarding ward rules; prepare patients/wardfor the physician's daily rounds

(Conditions) With minimum supervision but with the assistanceof the nursing care team; using necessary recordsIand equipment

(Criteria) According to ward and local command proceduresand/or BuMed regulations; patients, records andspecial equipment available and ready for thephysician's inspection and review

(Next Action) Inform ward supervisor or nurse in charge ofany corrective action that needs to be takenI regarding the physician's rounds or patientadmission procedures


Ward layoutCoordination abilitiesRelevant ward procedures, local commandpolicies and BuMed regulations

i11

!

Competency. ,, 7. If... .. . -,. ASSISTAN: (HAA)

Unit IV: Wr. r upor

MODULE 2: WA.I' SECURITY PROCEDU- S

TASKS a. Carry out office/area/unit securitymeasures

b. Recommiend ward/unit shakedown

PERFORMANCE OBJECTIVES

(Stimulus) When requested by ward supervisor(Behavior) The HAA will organize and supervise a security

check and/or patient shakedown, and report theresults to the ward supervisor, physician ornurse in charge

(Conditions) With minimum necessary supervision(Criteria) According to current local security regulations(Consequence) This action will result in an efficient and

secure ward/unit(Next Action) Inform all personnel on the ward of regulations

governing the inventory of patient's valuablesand property


Need for securityRelevant ward, hospital and BuMed security

regulationsPuupose/objectives and procedure for securitymeasures

Recognition of security breachesLeadership skillsEnforcement of regulations and policies

114

ICompetency: HOSPITAL ADMINISTRATIVE ASSIST- T (IHAA)

CQMPETENCY UNIT V: SUPPLY PROCEDURES

This unit includes thp following modules:INumber Title Page

I 1 Procurement and Inventory of Ward Supplies 16

Inventory and Requisition Procedures ... . 17

3 Maintaining and Transporting Supplies andEquipment ................. . 18

4 Linen Exchange Procedures .. ........ . 19

II

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Competency: HOSPITAL ADMNISTR.AT!'VE 3SIS'A'4T (HA.)

Unit V: Supply Procedures

MODULE 1: PROCURLyR.NT AND INVENTORY OF WARD SUPPLIES

TASKS a. Store suppliesb. Pctat? inventoryc. Prepare inventory reports


(Stimulus) Routinely oc when directed by ward supervisor(Behavior) The HAA will receive supplies upon their arrival,

perform an inventory and check against the sub-mitted requi!.4tion for any discrepancies, rotatesupplies, return outdated materials to supplyand prepare an inventory report for the concerneddepartments

(Conditions) With minimum supervision(Criteria) Supplies up-to-date and ready for immediate ward

use(Next Action) Fill in and accurately complete all necessary

forms to order supplies; give personnel on-the-jobtraining in procurement procedures


Location of suppliesOrganization and filingProcedures for ordering/inventorySupply rotation procedures

16

ICompetency: 11OSPITAL ADMINISTRATWE ASSIST. ( WA)


1.ODLE 2: INVENTORY AND REQUISITION PROCEDURES

TASKS a. identify/locate/check part numbers fromcatalogues and manuals

b. Prepare requisitions for supplies/equipmentc. Attach identifying tag to equipment and/or

component parts

PERFORMAkNCE OBJECTIVE

(Stimulus) Upon depletion of supplies, faulty operation ofequipment or when requested by the ward supervisor

(Behavior) The HAA will maintain an authorized inventory andwill prepare requisitions for needed supplies andequipment

(Conditions) Establishment and maintenance of ward inventorywill be performed with direct supervision; dailyinventory and requisition procedures with rinimalsupervision; using manuals, catalogues, requisi-tion forms

(Criteria) Maintains and orders all supplies and equipmentin accordance with current local inventory andrequisition policies; coordinates closely on adaily basis with other staff members within theward; properly utilizes necessary catalogues andmanuals; amount of on-hand stock depends upon theestablished usage factor and the base loadauthorized by local policies

(Consequence) Maintenance of an accurate and concise inventoryand attention to detail in requisitioning suppliesand equipment ensures an up-to-date stock ofsupplies ready for immediate use on the ward

(Next Action) Give personnel on-the-job training in procurementprocedures; maintain and transport necessarysupplies and equipment


Location of supplies and equipmentRequisitioning proceduresLocal supply procurement policiesCorrect usage of catalogues and manuals

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Cc:petency: h1OSPITAL AUCM_1.iS'ATIVE ASSIS. . 7 (iAA)

Unit V: Supply Prcced!.r ,s

DDULE 3: ?.AINTAINING A.,D TPANNSPORTINC SUPPLIES ]\ND EQUIPMET

TASKS a. Maintain stock o sterile suppliesb. Transport sterile ecTuip-ment/suppliesc. Return dirty or expired iters to central

supply roomd. Maintain stock of chemical solutions

PERFORM;NCE OBJECTIVE

(Stimulus) Routinely and when sterilized supplies and equip-rent are received

(Behavior) The HAA will perform sterilization checks uponarrival of supplies and equipment on the ward,rotate stock, dispense sterile supplies forimmediate ward use, and dispose of or returnunusable or outdated Lupplies to the centralsupply room

(Conditions) With minimal supervision(Criteria) According to local procedures, regulations and

required schedules(Next Action) Detect, record and report all unsterile supplies

and the source(s) of contamination, when known


Detection of contamination sourcesWhan and how to perform sterilization checksDisposal and reporting of unsterile suppliesProper handling procedures for sterile suppliesProcedures for transporting sterile supplies/

equipmentStock rotation principles and procedures

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Ii Cc-ipetency: HOSPITAL ADMINISTRATIVE ASSISTANT CHAA)


MODULE 4: LINEN EXCHANGE PROCEDURES

TASKS a. Prepare laundry list (NAVMED-6770/3)I b. Prepare linen inventory (NAVMED-6770/I)


I (Stimulus) When scheduled or when linen supplies are low(Behavior) The HAA will inventory, order and store ward

linen(Conditions) With minimal assistance and supervision; using

required forms(Criteria) According to local inventory procedures(Consequence) Maintenance of an adequate supply of linens forward requirements(Next Action) Maintain an up-dated inventory of linens


Location of linensProper linen storage techniquesInventory proceduresPreparation of laundry forms

I Procedures for submission of laundry forms

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HOSPITAL ADM4INISTRATION

I TECHNIC IAN

I7m

g Competency: HOSPITAL ADMINISTRATIVE TECHNICIAN (11AT)

CO11PETENCY UNIT I: CLERICAL OPERATIONS


Number Title Page

I Statistical Data Collection and Analysis * 21

2 Work order/Work Request. .. .......... 22

13 Admission and Transfer of Patient .. .. ... 23

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071-TaW0.7M

Co:mpetency: HOSPITAL ADMINISTRATIVE TECHNICIAN (HAT)


MODULE 1: STATISTICAL DATA COLLECTION AND ANALYSIS

TASKS a. Compile patient census statisticsb. Maintain patient status board/chart


(Stimulus) Daily or when requested by the ward supervisor(Behavior) The HAT will communicate with the nursing staff

to correlate daily information, compile patientcensus statistics, make necessary changes onth, patient status board/chart, complete required'orms on patients, prepare patient data forrequired reports and disseminate reports

(Conditions) Without supervision; using patient's chart andappropriate equipment, e.g., duplicator, calculator,optical scanner, flexiwriter, typewriter

(Criteria) Patient status and census information will becompiled accurately and concisely according tolocal and BuMed procedures

(Consequence) This action will provide latest patient Pataand status

(Next Action) Ensure proper routing of required reports


Compilation abilitiesPreparation of census statisticsNotification and routing proceduresLocal and BuMed regulationsUse, operation and preventive maintenance ofassociated equipment, e.g., typewriter, calculator,optical scanner, flexiwriter, duplicator

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.. WN IU4.

ICompeton'r-: HOSPITAL ADMINISTRATIVE TECHNICIA.. (HAT)


S MODULE 2: WORK ORDER/WORK REQUEST

TASKS a. Prepare work order/work requestj b. Receive and process material complaints


j (Stimulus) Upon receipt of a material complaint(Behavior) The HAT will fill in and complete a work order/

request, e.g., plumbing, electrical, painting,plastering, and forward the request to the proper

facility to have the repairs made(Conditions) Without supervision; using the necessary forms(Consequence) Timely submission of work orders or requests

prevents loss or damage to property and equipmentand eliminates hazards to personnel

I KNOWLEDGES AND SKILLS

Preparation of work order/work requestHazardous conditions

Public work instructionLocation of essential services, e.g., plumbing,Ipainting, plastering

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C-)mpetency: HOSPITAL ADMINISTRATIVE TECHNICIAN (FAT)


MODULE 3: ADMISSION AND TRANSFER OF PATIENT

TASKS a. Coordinate with hospital on admissions ofpatients

b. Coordinate patient transfer between medicalfacilities

c. Inform patient/family of VA hospital benefits


(Stimulus) When directed by the physician(Behavior) The HAT will make necessary arrangements for

intraward patient transfer (e.g., w.rd tosurgery) and/or for transfer from one medicalfacility to another, and collect and assemble allrecords pertaining to each individual patienttransfer

(Conditions) With minimal supervision(Criteria) All records and personal effects of the patient

are ready prior to actual transfer; according toward, local and/or BuMed policies

(Consequence) These actions will result in an orderly andefficient patient transfer


Pertinent local, ward and/or BuMed policies andprocedures

Patient types eligible for transfer to VA facilityModes of transportation

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Competency: I!OSPITAL ADMINISTPATIVE TECHNICIAN (HAT)

COMPETENCY UNIT II: SUPPLY PROCEDURES


Number Title Pace

1 Local Supply and Equipment Purchase .......... . 25

2 Supply and Equipment Accountability .......... . 26

3 Survey of Supplies and Equipment .. ......... .. 27

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Competency: HOSPITAL ADMINISTRATIVE TECHNICIAn7 (HAT)

Unit II: Supply Procedures

MODULE I: LOCAL SUPPLY AND EQUIPMENT PURCHASE

TASKS a. Inventory supplies/equipmentb. Establish supply usage ratec. Maintain voucher registerd. Log internal supply voucher (DDI50)e. Prepare requisitions for supplies/equipmentf. Inspect supplies/equipment for acceptability/

damage/loss/pilferage


(Stimulus) Ac .ording to schedule or when supplies are depleted(Behavior) Tde HAT will perform a supply/equipment inventory,

record supply usage rate, requisition neededsupplies and equipment for the wards, verifyrequisition voucher in register, and check thequality and quantity of supplies and equipmentdelivered

(Conditions) With minimal sipervision but with staff assistance(Criteria) Only specified supplies and equipment are received

unless items are acceptable to personnel placingthe original order, i.e., physician, nurse orcorpsman

(Next Action) Account for damaged supplies and equipment


Location and use of stock numbersUse of supply/equipment cataloguesRequest numbers for DD150Procedures to establish supply usage rateRequisitioning proceduresMaintenance of voucher registerCriteria for acceptance of delivered supplies/equipment

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Comoetencv: HOSPITAL ADMIIS7PATI V '. TI.NICIAN, (HAT)


MODULE 2: SUPPLY AND EQUIPMENT ACCOUNTAPILITY

TASKS a. Store instrumentsb. Maintain instrument calibration filesc. Log temporary loan cardd. Log plant property identification number

and condition


(Stimulus) Upon receipt and custody of office supplies andequipment

(Behavior) The HAT will perform an inventory, check equip-ment for damage, properly store supplies andequipment in allocated spaces, maintain properfiles and equipment status logs and maintain aloan card log

(Conditions) Without supervision(Criteria) According to established local and BuMed

regulations, policies and procedures(Consequence) Accurate record keeping ensures concise accountability

and proper management of equipment, includingobservance of security precuations against lossand pilferage

(Next Action) Update daily entries into all files and logs;f check out equipment to proper personnel


Instrument/equipment/supply storage temperatures,conditions and techniques

Preparation of loan cardsPlant property cardsMaintenance of instrument calibration files

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I r

Competeicy: HOSPITAL AD)NNISTRTIVE TECHNIC AN (HAT)


MODULE 3: SURVEY OF SUPPLIES AND EOUIPMENT

TASKS a. Dispose of outdated/expired supplies/equiprent

b. Datermine extent of damage/loss/pilferageof supplies/equipment

c. Prepare required reports and forms forreturn of damaged supplies/equipment


(Stimulus) Upon receiving supplies/equipment(Behavior) The HAT will inspect supplies or equipment to

determine the extent of any damage, loss orpilferage; notify the requestor of the state ofmaterials, and, if necessary, prepare the requiredforms for return or disposal

(Conditions) Without supervision(Criteria) According to local and BuMed directives(Consequence) These actions will ensure an accurate system for

supply and equipment disposal and/or return(Next Action) Issue supplies and equipment


Identification of defective itemsProcedures for inspection and acceptance of

suppliesReturnable supplies and equipment formsSupply and equipment disposal directivesPreparation of forms for disposal

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ICompetency: HOSPITAL ADM.TNISTR-TIVF TECHNICI- -& (HAT)

COMPETENCY UNIT TII: PEP.SO'7NEL RECALL

This unit includes the following module:

Number Title Pe

i 1 Personnel Recall ..... ................. . 29

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7inxetency: HOSPITAL ADMINISTRATIVE TECENICIAN (WA)

Unit I1: Personnel Recall

M'ODULE 1: PE11SOZZEL RECALL

TASKS a. Maintain duty/call/emegency recall rosterb. Initiate/carry out recall proce~ures


(Stimulus) When ordered(Behavior) The FAT will maintain a duty/call roster and

an rmergency Operation Plan (EOP)-type callroster and, when required, will initiate andcarry out personnel recall

(Conditions) With minimal supervision; using necessaryrosters, records

(Criteria) Accordihg to local dn(; BuNed policies; completingtotal recall procedures in a minimum time frame

(Consequence) Accurate and up-dated rosters result in an orderlyand totally efficient recall capability

(Next Action) Report to higher authorities as prescribed bycurrent directives


Location of recall records and rosterMaintenance of duty/call/emergency recall rostersProcedures for selection of recall personnelRecognition of recall situationsRecall procedures

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